Health Plan Facts, Trends and Data

Changing market conditions and new government initiatives are creating huge opportunities and even bigger risks for health plans. To succeed in today's health care business, you must have an effective way to track and forecast the big-dollar issues.

Health Plan Facts, Trends and Data is full of strategic intelligence that will help you stay ahead of your competition in this constantly changing arena. It's a well-organized resource packed with directories, analysis and other information on:

Industry-wide trends
Company news and events
State health reform initiatives
Financial performance and earnings results
Blue Cross/Blue Shield Plans
Benefit design models
Pharmacy benefit management
Medicare Advantage, Part D and managed Medicaid
Provider contracting and pay-for-performance measures
Technology initiatives
Federal regulations and legal issues
... and much more

The all-new 2008-2009 edition features coverage of topics such as:

Empire BlueCross BlueShield’s strategy to target small- and mid-sized employers in New York
M-Plan’s shutdown in Michigan and the subsequent endorsement of Anthem
Changes in the Nevada market due to UnitedHealth Group’s Sierra acquisition
Tactics for covering drugs with behind-the-counter (BTC) status
Outcomes from PreferredOne’s offer to discount deductibles for passed health tests
Class-action suits against leading health plans prompted by lowered earnings forecasts
UnitedHealth Group’s loss of two top-ranking execs
The creation of “hybrid” plan designs by combining traditional HMO and POS plans with consumer-directed health features
Response to new Department of Labor guidance that tightened restrictions for wellness incentive programs
Challenges in passage and implementation of initiatives such as Healthy San Francisco and Massachusetts’ universal health care
Federal debate on expanding SCHIP
Opportunities in marketing to baby-boomers
What a severe flu season means to the bottom line
Progress toward getting physicians to add e-visits to their practices

Make sure you're addressing the tough challenges ahead with the best information available. Order your copy of Health Plan Facts, Trends and Data today.

Also Available on CD: For an additional $150, you can order the convenient CD edition of Health Plan Facts, Trends and Data. The CD contains all of the information in the print edition and you’ll find what you need instantly with the user-friendly, searchable PDF format. Plus, all CD purchasers receive a free copy of the print edition!

Table of Contents

Chapter 1: Health Plan Industry Trends

Health Plan Enrollment Trends
Developing Industry Issues
Costs, Premiums and Profitability
Marketing Strategies and Partnerships
Executive Compensation Trends
Mergers and Acquisitions

Chapter 2: Health Plan Company Developments and Events

Health Plan Market Share and Expansion
Company-Specific Growth Strategies
MCO Organizational Structure and Leadership

Chapter 3: Health Plan Financial Performance

Second Quarter 2007 Results
Third Quarter 2007 Results
Fourth Quarter 2007 Results
Overall Results for 2007
First Quarter 2008 Results
Overall Results for 2008
Monthly MCO Stock Performance

Chapter 4: Blue Cross Blue Shield Plan Trends and Data

Blue Cross Blue Shield Plan News and Developments
Blue Cross Blue Shield Enrollment
Market Share and Competition
Blue Cross Blue Shield Conversions and Nonprofit Issues
Directory of Blue Cross Blue Shield Plans

Chapter 5: Benefit Design and Consumer-Directed Health Trends

Benefit Design Trends
Specialty Products
Product Launches and Coverage Expansions
Limited Benefit Plans
Product Partnerships and Group Initiatives
Employer Strategies
Consumer-Directed Health Trends and Challenges
Financial Institution Trends and Strategies

Chapter 6: Provider Contracting and Pay-for-Performance

Network Administration and Contracting Issues
‘Never-Event’ Policies
Overseas Medical Tourism
Pay-for-Performance Initiatives
Provider Ranking Issues and Conflicts
Quality Data Reporting

Chapter 7: Health Plan Tools and Technology

Personal Health Records and Data Innovations
Online and Educational Tools and Consumer-Support
Medical Technology Initiatives
Information Technology for Health Plans

Chapter 8: Health Promotion and Disease Management

Health Management and Utilization
Medical-Home Models
Strategies for Specific Health Issues
Wellness Programs

Chapter 9: Pharmacy Benefit Management Developments

Pharmacy Benefit Strategies
PBM Contracting
Pharmacy Costs and Trends
E-Prescribing Initiatives and Trends
Specialty Pharmacy Trends

Chapter 10: Medicare Advantage Business Strategies

MA and Part D Participation and Enrollment
Government Initiatives, Regulation and Funding
MA Marketing Issues
MA Product Development
Medicare Advantage Regional Data

Chapter 11: States and Managed Medicaid Markets

Managed Medicaid Developments and Events
Medicaid Contract Awards and Strategies
Medicaid Cost and Funding
Managed Medicaid Enrollment Data
Managed Medicaid Market Share Data

Chapter 12: State Health Reform Initiatives

State-Level Universal Health Care Reform
State Initiatives
State Coverage Expansions

Chapter 13: Legal Issues and Federal Regulations

Federal Health Care Reform and Legislative Efforts
California Rescission Developments and Events
Provider Relationships
Data Protection and Security
Antitrust and Fraud and Abuse Issues
Health Liability and Legal Issues

Chapter 14: Health Plan Resources and Directories

Directory of Federal and Regional Medicare Regulators
Directory of Health Plan Trade Associations
Directory of Health Plan Accrediting Bodies
Directory of State Health Plan Associations
Directory of State Insurance Commissioners
Directory of State Medicaid Directors
State Medicaid Pharmacy Directors
State Health Officials

Master Table of Contents
Index of Charts

Written By

Health Plan Facts, Trends and Data was written and edited by the editorial staff of Atlantic Information Services.

Written For

Managers of HMOs, PPOs, POS plans and PSOs
Hospital managers and health system executives
Group practice managers
Managers of IDSs
Insurance executives
Employee benefits managers
Consultants and attorneys

AIS Guarantee

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Related Publications

Health Plan Week
Drug Benefit News
Medicare Advantage News
Managed Medicare and Medicaid Factbook
The AIS Report on Blue Cross and Blue Shield Plans
Pharmacy Benefit Trends & Data
Inside Consumer-Directed Care
AIS's Directory of Health Plans
AIS’s 2003-2007 Health Plan Enrollment Statistics
Consumer-Directed Health Care Facts, Trends and Data

For further information call 800-521-4323 or e-mail customerserv@aispub.com